What Is VSED (Voluntarily Stopping Eating and Drinking)? A Complete Guide
By CRYSTAL BAI •
The short answer: VSED (Voluntarily Stopping Eating and Drinking) is a legal end-of-life option in which a mentally competent person chooses to stop all food and fluids, leading to a natural death within 1 to 3 weeks, supported by hospice comfort care.
VSED: A Complete Guide to Voluntarily Stopping Eating and Drinking
Voluntarily Stopping Eating and Drinking (VSED) is a legal, patient-directed end-of-life option in which a mentally competent person chooses to stop consuming all food and fluids. For people with terminal illness or unbearable suffering, VSED offers a way to hasten death without physician-assisted dying, which is not available in all states.
Who Is Eligible for VSED?
VSED requires:
- Decision-making capacity: The person must be mentally competent at the time of the decision and throughout the process
- Voluntary choice: The decision must be free from coercion
- Informed consent: Full understanding of the process, timeline, and symptom experience
VSED is available to adults regardless of diagnosis, prognosis, or state of residence, making it an option where physician-assisted dying laws do not apply.
The VSED Process
Before beginning VSED:
- Consult with physicians, palliative care team, and hospice
- Complete advance directives specifying VSED wishes
- Discuss with family and caregivers who will be present
- Consider consulting a social worker, chaplain, or death doula
During VSED, hospice teams provide comfort measures including frequent mouth care for dryness, medications for anxiety and discomfort, and regular assessment of the person's wellbeing.
What to Expect During VSED
The first few days may involve hunger and thirst, managed with oral care and small ice chips. As the body enters ketosis, hunger typically subsides. Sleep increases. Consciousness gradually decreases over days to weeks. Death typically occurs peacefully with proper support.
Ethical and Spiritual Considerations
VSED raises questions for some religious traditions around suicide. Most ethical frameworks distinguish VSED from suicide, viewing it as refusing unwanted treatment. Consulting with a chaplain or spiritual advisor aligned with one's tradition can help clarify these questions.
Death Doula Support for VSED
Death doulas are valuable companions through VSED, providing daily presence, emotional support for both the patient and family, and advocacy with care teams. Renidy can connect you with death doulas experienced in supporting families through the VSED process.
Frequently Asked Questions
What is VSED?
VSED stands for Voluntarily Stopping Eating and Drinking. It is a legal end-of-life option in which a person who is mentally competent chooses to stop consuming food and fluids, leading to a natural death within days to weeks.
Is VSED legal?
Yes, VSED is legal throughout the United States and in many other countries. Because it involves refusing medical intervention (nutrition and hydration), it is considered an exercise of a patient's right to refuse treatment.
How long does VSED take?
The process typically takes 1 to 3 weeks from the time eating and drinking fully stop, depending on the person's underlying health condition, age, and body composition.
Is VSED painful or comfortable?
With proper hospice and palliative care support, VSED can be made very comfortable. Symptoms like dry mouth are managed with mouth care, and medications control any discomfort or anxiety during the process.
Who chooses VSED?
VSED is typically chosen by people with terminal illness, advanced disease, or unbearable suffering who want to hasten death without physician-assisted dying — including people in states where medical aid in dying is not available.
Renidy connects grieving families with compassionate death doulas and AI-powered funeral planning tools. Try our free AI funeral planner or find a death doula near you.